Korean J Urol.  2007 Oct;48(10):1069-1074. 10.4111/kju.2007.48.10.1069.

The Factors Affecting the Success and Quality of Life after a Tension-free Vaginal Tape Procedure in Patients with Stress Urinary Incontinence

• Ko KT
• Lee SH
• Kim HY

• KMID: 2139741
• DOI: http://doi.org/10.4111/kju.2007.48.10.1069

Abstract

PURPOSE: The factors affecting the success and quality of life following a tension-free vaginal tape(TVT) procedure were investigated in patients with stress urinary incontinence.
MATERIALS AND METHODS
We included 79 women with stress urinary incontinence that underwent the TVT procedure and were followed for at least 3 years. Preoperatively, the patients were evaluated by history, physical examination, a 1-hour pad test, and videourodynamics to determine the abdominal leak point pressure(ALPP). In addition, pre- and postoperative quality of life was evaluated by the incontinence quality of life questionnaire(I-QoL). We analyzed factors including patient characteristics, history, 1-hour pad test and ALPP with respect to the success and quality of life after the TVT. A success after the TVT was defined as the absence of any subjective complaint of leakage.
RESULTS
The overall 3-year success rate of the TVT was 90%. There was a statistically significant increase in the I-QoL scores postoperatively. There were no significant preoperative factors affecting the success rate and the postoperative I-QoL scores. However, when the postoperative I-QoL scores were compared with the preoperative scores, the increase in the I-QoL scores was significantly higher in the patients with urge incontinence, low ALPP and high-grade incontinence.
CONCLUSIONS
The results of this study suggest that the TVT procedure is effective for treating female stress incontinence and improving the quality of life without any independent risk factors. However, for improving the quality of life, the TVT was more effective in women with stress urinary incontinence with urge incontinence, low ALPP and high-grade symptoms.

Keyword

Urinary stress incontinence; Surgical mesh; Quality of lif

MeSH Terms

Female
Humans
Physical Examination
Quality of Life*
Risk Factors
Suburethral Slings*
Surgical Mesh
Urinary Incontinence*
Urinary Incontinence, Stress
Urinary Incontinence, Urge

Reference

1. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996. 7:81–86.

2. Nilsson CG. The tension free vaginal tape procedure (TVT) for treatment of female urinary incontinence. A minimal invasive surgical procedure. Acta Obstet Gynecol Scand. 1998. 168:34–37.

3. Moran PA, Ward KL, Johnson D, Smirni WE, Hilton P, Bibby J. Tension-free vaginal tape for primary genuine stress incontinence: a two-centre follow-up study. BJU Int. 2000. 86:39–42.

4. Ulmsten U, Falconer C, Johnson P, Jomaa M, Lanner L, Nilsson CG, et al. A multicenter study of tension-free vaginal tape (TVT) for surgical treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1998. 9:210–213.

5. Olsson I, Kroon U. A three-year postoperative evaluation of tension-free vaginal tape. Gynecol Obstet Invest. 1999. 48:267–269.

6. Ulmsten U, Johnson P, Rezapour M. A three-year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Br J Obstet Gynaecol. 1999. 106:345–350.

7. Nilsson CG, Kuuva N, Falconer C, Rezapour M, Ulmsten U. Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2001. 12:Suppl 2. S5–S8.

8. Nilsson CG, Falconer C, Rezapour M. Seven-year follow-up of the tension-free vaginal tape procedure for treatment of urinary incontinence. Obstet Gynecol. 2004. 104:1259–1262.

9. Kim NS, Bae JH, Lee JG. long-term follow-up of the tension-free vaginal tape (TVT) procedure for treating female stress urinary incontinence. Korean J Urol. 2006. 47:729–733.

10. Doo CK, Kim JB, Kim WS, Park JS, Chung BJ, Kim JY, et al. Predictive factors affecting long-term cure and patient satisfaction of the tension-free vaginal tape procedure for the treatment of female stress urinary incontinence. J Korean Continence Soc. 2006. 10:9–16.

11. Cetinel B, Demirkesen O, Onal B, Akkus E, Alan C, Can G. Are there any factors predicting the cure and complication rates of tension-free vaginal tape? Int Urogynecol J Pelvic Floor Dysfunct. 2004. 15:188–193.

12. Gordon D, Gold R, Pauzner D, Lessing JB, Groutz A. Tension-free vaginal tape in the elderly: Is it a safe procedure? Urology. 2005. 65:479–482.

13. Paick JS, Ku JH, Shin JW, Park K, Son H, Oh SJ, et al. Significance of pad test loss for the evaluation of women with urinary incontinence. Neurourol Urodyn. 2005. 24:39–43.

14. Rodriguez LV, de Almeida F, Dorey F, Raz S. Does Valsalva leak point pressure predict outcome after the distal urethral polypropylene sling? Role of urodynamics in the sling era. J Urol. 2004. 172:210–214.

15. Paick JS, Ku JH, Shin JW, Son H, Oh SJ, Kim SW. Tension-free vaginal tape procedure for urinary incontinence with low Valsalva leak point pressure. J Urol. 2004. 172:1370–1373.

16. Jeffry L, Deval B, Birsan A, Soriano D, Darai E. Objective and subjective cure rates after tension-free vaginal tape for treatment of urinary incontinence. Urology. 2001. 58:702–706.

17. Ku JH, Shin JW, Son H, Oh SJ, Kim SW, Paick JS. Predictive factors for persistent urgency or urge incontinence after tension-free vaginal tape procedure in mixed urinary incontinence. Korean J Urol. 2004. 45:330–336.

18. Kulseng-Hanssen S, Husby H, Schiotz HA. The tension free vaginal tape operation for women with mixed incontinence: Do preoperative variables predict the outcome? Neurourol Urodyn. 2007. 26:115–122.

19. Rezapour M, Ulmsten U. Tension-free vaginal tape (TVT) in women with mixed urinary incontinence: a long-term follow-up. Int Urogynecol J Pelvic Floor Dysfunct. 2001. 12:Suppl 2. S15–S18.

20. Blaivas JG, Appell RA, Fantl JA, Leach G, McGuire EJ, Resnick NM, et al. Standards of efficacy for evaluation of treatment outcomes in urinary incontinence: recommendations of the Urodynamic Society. Neurourol Urodyn. 1997. 16:145–147.

21. O'Connor RC, Nanigian DK, Lyon MB, Ellison LM, Bales GT, Stone AR. Early outcomes of mid-urethral slings for female stress urinary incontinence stratified by valsalva leak point pressure. Neurourol Urodyn. 2006. 25:685–688.

22. Donovan J, Bosch R, Gotoh M, Jackson S, Naughton M, Radley S, et al. Abrams P, Cardozo L, Khoury S, Wein A, editors. Symptom and quality of life assessment. Incontinence 3rd International consultation of incontinence. 2005. Plymouth: Health Publication;519–584.

23. Pozowski J, Sobanski A, Dudkiewicz D, Michalski B, Ulman-Wlodarz I. Quality of life in women with urinary stress incontinence and evaluation of tension-free vaginal tape treatment. Gynecol Obstet Invest. 2007. 64:55–60.

24. Bjelic-Radisic V, Dorfer M, Greimel E, Frudinger A, Tamussino K, Winter R. Quality of life and continence 1 year after the tension-free vaginal tape operation. Am J Obstet Gynecol. 2006. 195:1784–1788.

25. Vassallo BJ, Kleeman SD, Segal JL, Walsh P, Karram MM. Tension-free vaginal tape: a quality-of-life assessment. Obstet Gynecol. 2002. 100:518–524.

26. Wagner TH, Patrick DL, Bavendam TG, Martin ML, Buesching DP. Quality of life of persons with urinary incontinence: development of a new measure. Urology. 1996. 47:67–71.

27. Patrick DL, Martin ML, Bushnell DM, Yalcin I, Wagner TH, Buesching DP. Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QoL). Urology. 1999. 53:71–76.

28. Donovan J, Bosch R, Corcos J, Gotoh M, Kelleher C, Naughton M. Abrams P, Cardozo L, Khoury S, Wein A, editors. Symptom and quality of life assessment. Incontinence. 2002. 2nd ed. Plymouth: Health Publication;267–316.

29. Oh SJ, Park HK, Lim SH, Hong SK, Martin ML, Ting BL, et al. Translation and linguistic validation of Korean version of the Incontinence Quality of Life (I-QoL) instrument. J Korean Continence Soc. 2002. 6:10–23.